The mental functions required to organise, begin and complete a task can be thought of as our “executive functions”. Take a moment to think about how we succeed in everyday life. Each day we engage in a series of goal directed tasks or activities, from simple tasks like getting dressed through to more complex activities like completing an essay or a tax return.
Getting a task done involves recognising or remembering that the task needs to be done, paying attention to the task at hand, resisting distraction, finding the motivation to get started, making a plan if the task is complex, locating important tools or objects, persisting in the face of boredom or frustration, monitoring progress, and making changes as needed until the task is complete.
Just like the conductor of an orchestra, who directs musicians to start and stop playing, our “executive functioning system” tell us when and how to engage in particular behaviours. If the conductor of the orchestra disappears, the orchestra will have a hard time performing to a high standard. If our executive functioning system is not operating effectively, we will have a hard time completing necessary life activities in line with our goals and needs.
ADHD can be thought of as a neurodevelopmental disorder of executive functioning. Children and adults with untreated ADHD have persistent trouble staying on task. They find it hard to complete appropriate activities at the appropriate times. They find it hard to avoid distraction and to delay rewards. They can act impulsively and without proper planning. And they usually struggle to find the motivation to get started on boring or mentally challenging tasks.
ADHD remains very poorly understood by the general public, and unfortunately it is similarly misunderstood by most health professionals.